Listener discretion is advised. This episode features discussions of violence, abuse and murder involving children. We advise extreme caution for listeners under 13.

Terrible habits are hard to break, especially when they've made you rich. Notorious baby farmer Amelia Dyer learned this the hard way. Despite multiple stops and starts and even prison time, she killed upwards of 400 infants over three decades, no matter how many times she was pushed back to the straight and narrow. Amelia was always pulled back into murder.

The allure of money was just too great. She never broke the habit.

This is Medical Murders, a Spotify original from podcast, every year, thousands of medical students take the Hippocratic Oath. It boils down to do no harm. But a closer look reveals a phrase much more interesting. I must not play it God. However, some doctors break that oath. They choose to play God with their patients, deciding who lives and who dies each week on medical murders. We'll investigate these doctors, nurses and medical professionals. We'll explore the specifics of how medical killers operate not just on their patients but within their own minds, examining the psychology and neurology behind heartless medical killers.

I'm Alastair Murden and I'm joined by Dr. David Kipa, M.D..

Hi, everyone. I'm Dr. Kipper and excited to join Allaster to dive deeper into the story of Amelia Dyer, the baby killer. Now that she's been released from incarceration for her heinous crimes, will her release actually temper or embolden her? Let's find out.

You can find episodes of medical murders and all other podcast originals for free on Spotify or wherever you listen to podcasts to stream medical murders for free on Spotify. Just open the app and type medical murders in the search bar. This is our second episode on Amelia Diar, a trained nurse and midwife who some say killed as many as 400 infants. She found her victims through a business known as baby farming. Last week, we explored the twisted history of Amelia Dyer and the shocking law that helped keep baby farms in business.

This week, we will dive into Amelia's later years and how authorities finally shut her down. All this and more coming up.

Stay with us. It started with a baby's muted cries a few moments later, the struggle ended and 59 year old Amelia Dyer held a limp body in her arms. She'd killed hundreds of babies in the past, and Helena Frye was no different. The little girl had a cord of white tape wrapped around her neck, and Amelia didn't bother to remove the murder weapon. She simply wrapped the baby's body up in the newspaper and brown packing paper. Then after the parcel had sat in her home for a brief period of time, she headed out into the cool English night.

It was a routine she followed dozens of times, always leading to the banks of the River Thames. She threw the bag into the water with utter callousness.

Amelia embodied an inhuman evil, and it seemed she was destined to continue this path of murder and deception until her death.

But it didn't have to be that way. 15 years before British authorities gifted Amelia a second chance in February 1880, they released her from prison after she served six months back at home with her family. Amelia did her best to move on with a normal life, but she found it hard to find any respectable work in Tatta, down a suburb of Bristol.

Everyone in the neighborhood knew what Amelia had done, they saw past the light sentence she killed babies.

So in 1881, shortly after her release, the family packed up their things and left Tatta down. They moved about a mile north near Bristol City Center. There, Amelia's husband, William, found work in a local brewery, even though it was only a short distance from their old home. Few people identified Amelia as the felon who'd made papers for all she could tell she had a chance to start fresh, something the family was grateful to have. Her husband and children were, at the very least, vaguely aware of Amelia's true deeds.

And though they agreed to look past them, they wanted as much distance from the past as they could get. But even removed from the past, Amelia still worried about money, so she did laundry for the neighborhood. The income was small, but it was honest work. After a few months of this, Amelia felt exhausted, but she had no idea. The family lived off of a pretty busy street, and Amelia decided to open up a general store.

It seemed to everyone, including Amelia's husband William, and her youngest daughter, eight year old Marianne, that she had rounded a corner. But like before, honest work proved too difficult for Amelia Dyer.

Owning and operating a general store wasn't as easy as Amelia hoped for, one, the family needed to pay hundreds of pounds a year in operating costs worth tens of thousands of dollars today. In addition, they're busy. Neighborhood was fraught with competition, and Amelia didn't have enough capital to drive her prices down. As a result, the business floundered. Year after year. Amelia's profits dwindled and she was barely able to keep the store afloat. Eventually, by the end of 1893, Amelia decided it was time to cut her losses and close up shop.

It was heartbreaking for Amelia. She had worked so hard for three years, only to come up short again. William was still bringing in steady money. However, his income scarcely covered rent. If he got hurt on the job, then that was it for the family.

It's also possible the general store put the family in debt, a sum that Amelia wanted to get rid of. Deep down, Amelia knew there was only one move to make. By early 1884, Amelia Dyer placed ads in the local newspaper offering to adopt new children. The decision didn't come lightly. She didn't care about the crimes, but she worried about getting caught. If she was, her family might end up on the street just as if she'd never worked at all.

But learning from past mistakes, Amelia decided to focus on higher end clients. She hoped to play on the wealthier classes naivety in her ads. Amelia used a pseudonym, upped her rate and sometimes claimed to be a woman who hopelessly wanted a child. She promised that she was capable and would cherish the child as if her own. At the time, orphanages often refused to take children from single mothers, so they were forced to find a family on their own.

Amelia knew that women who had babies out of wedlock still wanted to believe that their children could live a safe, happy life. Despite the perceived logic behind it, giving up their children must have been really painful for many of these women. During pregnancy, women go through some big hormonal shifts that influence their emotions and behaviors. They develop a natural protectiveness and deep affection for the life growing inside them.

The key players involved here are estrogen and oxytocin, the hormone responsible for the loving attachment a mother feels for her child. In a sense, this biochemical change in a pregnant woman primes her psychologically. So afirm maternal instinct is established when the baby is born. It's a natural motivation for mothers to do what they feel is best for their children. Unfortunately, these women brought their babies to Amelia Dyer, she knew how to play the part and occasionally sent her own children out for the day when clients came by.

She often made appointments when her husband would be at work because he didn't approve of Amelia's crimes, though he wasn't upset enough to leave her over it. William Diene knew the family had barely escaped ruin. The first time to these mothers, Amelia appeared to be the perfect caregiver. She put on a sweet, motherly heir and claimed she and her husband had always wanted a baby of their own successfully conned. These women gladly gave Amelia their children and a large sum of money they left confident that their infants would grow up in such a healthy environment.

However, a few days later, Amelia killed their babies, it's believed that she usually smothered the newborn infants because if done correctly, it left little to no trace of foul play. Smothering isn't an easy way for anyone to go, especially a small child. Strangulation is a much quicker way to die. But if you're the killer, you're trying to avoid any physical or external signs of trauma. This would happen in strangulation, but would not happen in smothering.

When someone is smothered to death, they die from asphyxiation or a compromise breathing pattern that denies the body of needed oxygen without any oxygen entering the lungs. The body quickly goes into a state of generalized hypoxia where the vital organs and tissues aren't getting enough oxygen to work properly. After a couple minutes of applied pressure, the infants passed away in Amelia's arms.

Amelia Dyer never seemed fazed by these horrid acts, but her family tried to distance themselves. Her husband, William, had no part in it and increasingly tried to spend as much time at work as possible. He understood how important the business was to the family's income, but it made him sick. He couldn't imagine how he'd feel if someone harmed his children in any way, let alone killed them.

Still, he did nothing to stop his wife. As for the two children, they didn't fully understand what was going on. They realized Amelia's job was baby farming, but they didn't grasp the true brutality of it. It's possible that Amelia ensured her own children weren't around when she committed murders. Amelia was more perceptive on this second go around. She'd learned from her previous run ins with the law and made sure that she spread out how many babies she took in at a time.

Amelia also no longer kept her victims alive for weeks, as she had before. Too many children in the house might arouse suspicion among the local undertakers who came to take the bodies. Most historians believe that hundreds of mothers were fooled by Amelia's pseudonyms in the papers, photojournalism was in its infancy, even if people had heard of Amelia in the news.

Few knew exactly what she looked like to further evade suspicion. The Dyer family moved again in 1885. William found a job at a factory a few miles away.

Unshackled by her past and sure of her new business strategy, Amelia was free to thrive, but she knew things couldn't last forever in her new home.

Amelia began to feel the toll of her work. Each baby provided plenty of cash but increased the risk she'd get caught. She interacted with undertakers and new mothers all the time. Each new victim could bring everything crashing down for two years. Amelia escaped detection. Until one distraught mother came back to see her child and brought authorities with her.

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Now back to the story. After 48 year old baby farmer Amelia Dyer and her family moved to fish ponds, a small suburb a few miles from downtown Bristol, Amelia's latest baby farming operation thrived between 1885 and 1887. Amelia moved her family at least one more time to a different part of the city in each place. Amelia conned hundreds of British pounds from desperate mothers. In 1890, a governess for a wealthy family reached out to Amelia through one of her many newspaper ads.

This woman was expecting a baby out of wedlock to avoid suspicion and scandal. She hoped to give the child to a loving family when she met Amelia. She was pleased by what seemed like a perfect environment. The governess lived with Amelia for at least two months until she gave birth. Amelia assumed this would be like any other time after the birth. The governess left shortly after. Maybe within a few days, Amelia killed the baby. We don't know the details of this death, but Amelia usually smothered the children.

Amelia believed that was the end of the story.

But two months later, the governor's came back to see Amelia per their agreement, this was to be Amelia's payday on which she'd receive a final sum of 15 pounds. The governor's really did love her child and wanted to check up. Amelia was immediately flustered. Amelia went into the house and retrieved an infant to show the governess. The young woman's heart fluttered when Amelia put the baby in her arms. However, this brief bit of joy turned to confusion. Something wasn't right.

This baby wasn't hers. Amelia assured her that this was her child, but the governess was steadfast in her accusation. The most damning piece of evidence came when the governess couldn't find her baby's birth mark. She demanded an explanation, but Amelia didn't budge.

The tense conversation continued for a few moments before Amelia snatched the baby back and demanded the governess leave the property. But the governess didn't give up easily. She continued to show up at Amelia's door. Over the next few weeks, though, a precise timeline is unclear. On the occasions that Amelia actually met with the mother, she remained cold and distant while the woman begged to see her baby. Eventually, Amelia lied and said the baby had been sent to live with another family.

She gave vague details of where this new family lived, grasping at straws. The mother went searching but couldn't find any trace fed up.

She returned to the Diya home again, but no one was there. The family had packed up their things and left. According to a 1991 census, William falsely referred to himself as a widower. His children, likewise, were said to be growing up without a mother. Meanwhile, Amelia went to live in a boarding house a few miles from her family's home. She worked there for a few months until she believed the governess had given up, despite the close call when Amelia rejoined her family.

She didn't show any signs of slowing her business down. She continued to play in the newspapers, and her daughter Maryanne saw more babies come into the house alive and leave dead. As Maryanne got older, she likely became fully aware of her mother's hand in these babies deaths.

But it seems that she wasn't fazed. Almost a year later, in October 1891, the governess finally tracked Amelia down, this time she wasn't alone.

A police officer accompanied her and they were eager to question Amelia, while Amelia's heart must have raced.

She remained cool, calm and collected in front of the officer. She parroted the story she told the governess months before the baby was now living with another family. She didn't know where they resided. At this point, if the governess wanted to see her baby, she needed to leave and find this other family. After a few more minutes of questioning, the authorities left. While the case was intriguing, they found no evidence of foul play. The governess was on her own.

Amelia momentarily breathed a sigh of relief, but that was quickly replaced by a renewed sense of panic. She had been in prison before and didn't want to get caught again. Not only with the sentence be harsher, but Amelia's family would end up on the street, a reality that she had been trying to escape for over two decades. According to Alison Rattle and Alison Vale, historians and authors of Amelia Dyer, Angel Maika, the woman who murdered babies for money, the pressure all came crashing down on Amelia at once.

She had what appeared to be a psychotic episode. By some accounts, Amelia threatened to take her own life by slashing her neck and wrists. She screamed at the family and barely slept a wink. Not sleeping well and threatening suicide are definitely components of a psychotic break. But to truly be a psychotic break, we need to have delusions and hallucinations. The psychotic episode is an acute state of psychosis or a condition that distorts a person's perception of reality and thought processes.

These episodes can be very disarming and disturbing on a biological level. Psychotic episodes are brought on by too much cortisol in the system. Cortisol is a hormone your body makes as a response to stress. Cortisol is important to our evolution as a species because it enabled our fight or flight response to danger. When we're stressed, our adrenal glands secretes cortisol, resulting in a surge of activating neurotransmitters like norepinephrine that physically stimulate us.

This flood of activating neurotransmitters then triggers an intense dopamine response, which collectively can create a psychotic state.

Some common symptoms include hallucinations, delusional thinking, paranoia and suicidal ideation or actions. These are hallmark signs that the very real and serious problem.

The episode took the dive family by surprise. Amelia had held everything in so well over the past few decades. On November 13th, 1891, Amelia's husband, William, summoned the doctor to assess his wife despite her nefarious acts, he might have still loved her and wanted her to get well. The physician agreed that this episode was serious. He then had Amelia admitted to a local asylum. In hindsight, it's unclear if Amelia's breakdown was all for show or a real mental health crisis.

After all, Amelia had been under police suspicion and once worked in an asylum. She knew it could be manageable if she just followed all of the rules she was given. It might even make the perfect hideout. However, some believe the psychotic episode might have been caused by the lingering effects of her laudanum addiction.

What provokes a psychotic episode is sometimes tricky to diagnose, but they do often have a footing and drug addiction when abusing drugs that arouse a nervous system like cocaine or methamphetamine, users experience an exaggerated dopamine response. And this can trigger psychotic episodes, especially one associated with a sudden rise in stress hormones. Conversely, depressant drugs like alcohol or the opiate laudanum in the case of this story, will slow our nervous system down and don't create the same activating dopaminergic reactions that send people into psychosis.

For Amelia to become psychotic due to her laudanum addiction, she would have really needed to be in withdrawal. This severe activation of the nervous system only occurs with depressant drug addiction. When those substances are acutely withdrawn. The brain's way of saying get me more. The stress of the nervous system then triggers a severe cortisol spike. And this combination of chemical events can potentiate a psychotic episode. It's difficult to say for certain what Amelia experienced, but it's clear that at the time local doctors felt her condition was serious.

Amelia stayed in the asylum for two months. By all accounts, she was a model patient. Amelia appeared calm and polite. She exhibited no signs of the rage or, quote, volubility that sent her there. Eventually, doctors assessed that she was cured and released her on January 12th, 1892. She moved back in with her family, but weeks later, they returned to their first neighborhood of Tatta. Down there, Amelia's baby farming business surged. Maryanne's saw as many as four ladies in the house at a time.

Yet their time there never lasted long. After the women gave birth, they were gone. If the babies survived being born and remained in the dire household, they wouldn't stay alive for long.

It's estimated that during this period in Tottered Down, Amelia killed dozens of babies and her cruelty was on full display. Historians Alison Rattle and Alison Vale reported that a young mother came to Amelia eager to find a good home for her child, who had a medical condition. Amelia looked at the innocent baby and back to the mother.

She didn't miss a beat with a sly smile. She said that she would arrange regular checkups with the physician. The young woman looked relieved. She was grateful for Amelia's generosity.

Not many other people looking to adopt would want a sick child. Confident in Amelia's sincerity. The mother kissed her child one last time and handed Amelia the only thing the baby farmer cared about the cash.

A week later, the baby was dead and Amelia was richer for it.

It's clear 1892 was especially profitable for Amelia because by the end of the year, she moved the family into a larger house. But while Amelia lived an extravagant life, her work may have started deeply affecting her. The family reported that Amelia started taking the opiate laudanum again and drank hard liquor every day. It's possible with her increased cash flow. She felt more comfortable spending money on her addiction. But either way, Amelia's actions were often erratic, and she showed no signs of getting better.

Her daughter, 21 year old Marianne, sought an escape and found it in the hands of a successful young businessman, Arthur Palmer, while this was a positive development for Maryann, a dark cloud reappeared in Amelia's life in December 1893. The governess came back demanding to see her child. Amelia very likely stonewalled and repeated the same story until the governess left. But this reappearance had Amelia spooked a few days later. Amelia was again admitted to an asylum. A month later, on January 20th, 1894, doctors released Amelia, but when she returned home, her husband, William, was gone, too.

Apparently, he couldn't stomach Amelia's work anymore. Amelia took this opportunity to cut her losses and shut down and moved again. From there, Amelia's life entered into a new pattern. Any time a merely a sense, the authorities hot on her trail, she came up with a dastardly plan to get away. She either returned to an asylum, which might have been intentional or quickly packed her things for a new town. Over the next 18 months, Amelia committed herself at least two more times and crisscrossed the southern U.K. by August of 1895.

She landed just outside of Redding, about 80 miles east of Bristol. Her daughter, Maryanne, and her husband Arthur moved in with her. Arthur was recently unemployed, so the couple now depended on the baby farming business. After her latest close calls. Amelia grew more cautious. She realized that, including the undertaker, which created a paper trail, risked her business and freedom. Not only could it evoke suspicion, but it also cuts into Amelia's bottom line.

The undertakers services and the obligatory funerals weren't free. So Amelia decided to dispose of the bodies herself at the same time. Amelia changed her modus operandi. For unknown reasons, possibly because the thrill was gone, Amelia didn't hold a pillow over the babies to smother them anymore. Instead, she slowly wrapped white edging tape used to make dresses around their necks to strangle them. What these children experienced must have been unbearable.

One could argue that there's something more callous about strangulation than smothering, while smothering just involves restricting someone's oxygen intake. Strangulation involves compression of the jugular veins and carotid arteries, crushing the trachea and stimulating the carotid sinus reflex, which dangerously lowers blood pressure and heart rate. All of these concurring mechanisms result in a very brutal death that can take minutes. It's important to consider specific circumstances, but on a gut level, there's something more cruel about physically brutalizing these vital structures in the neck than simply depriving someone of respiration.

The callousness of these acts didn't escape Marianne and Arthur, but there was little they could do.

Maryanne wouldn't turn in her mother. She loved her, and Arthur knew Amelia brought in the majority of their income.

Without her, they wouldn't survive. By some accounts, they even carried out their own baby farming schemes. So the couple didn't stop Emilia when they saw her, wrapped the dead bodies in old newspapers and weigh the packages down with bricks. Amelia made sure these bundles were secure tightly before heading out in the dead of night.

She weaved her ways in and out of the tight streets of Redding before she reached Clapper's footbridge that spans the River Thames. There, she took a moment to make sure that no one saw her and tossed the package in the water. She silently stood there until the current took the baby down river and under the surface.

It can actually take quite a bit of force to get a body to sink as human beings are naturally very buoyant in life and in death without weight to submerge it, a body will float until water completely fills the lungs, displacing any trapped air. The sunken body will then resurface in about a week as its putrefaction leads to gas formation and the tissues.

Some of these gases include carbon dioxide, hydrogen, methane and ammonia. Knowing this, Amelia must have used a lot of weight to ensure her victims would sink.

Amelia perfected this morbid routine over the next six months in reading until late March 1896. Coming up, a body is discovered and authorities apprehend Amelia now back to the story.

The morning of March 30th, 1896, proved to be typically cold and damp on the River Thames, dozens of bargemen made their way through the choppy waters, trying to get their cargo safely to their various destinations. It was difficult work that required the men to keep their eyes peeled for anything unusual in the water. A submerged log might cause serious damage to one of their boats.

So when an experienced member of the crew noticed something odd floating, he stuck out his pole to see if he could hook whatever it was and hold it aboard. He peeled back the layers of wet paper and discovered the body of an infant. He hollered to his foreman. The police were summoned to the scene when Detective Constable James Beatty Anderson arrived. He was shocked to see the body of a baby with a white piece of tape wrapped around its neck. He knew immediately that this was a case of foul play.

Luckily for Anderson, the paper the baby came wrapped in was well preserved. On the outside, there was an address for a home in a small Bristol suburb. Within the day, he contacted the authorities in Bristol to discuss the case. Authorities in Bristol linked the address to the former home of Amelia Diar and one of her aliases, Miss Thomas, using this information. Anderson tracked down Amelia's home in Redding. From there, he directed officers to observe the property.

They saw a few mothers come and go. Anderson then ordered a colleague to answer one of Amelia's ads. After establishing contact and confirming Amelia's services, the police department scheduled a meeting with Amelia at her home. This time, there was no running for Amelia Dyer. She was arrested on the night of April 3rd and taken to jail, where she awaited trial, this time on suspicion of murder. Authorities interviewed Amelia, but she wasn't willing to give up any information, she played as coy as she had in her other interactions with the police, but she couldn't escape, this time with Amelia in their custody.

Authorities dredged a section of the River Thames near where the infant was found and discovered an additional six babies, each one with white tape wrapped around their necks.

Authorities had evidence of murder and precedent from the last case in Bristol. This wasn't neglect. On top of that, several mothers who entrusted Amelia with their children came forward to report that they hadn't seen them since.

Amelia couldn't explain her way out of custody.

The best she could do was save her family. The authorities knew that there was no way that the Diyas were unaware of what went on behind their closed doors. But Amelia admitted her guilt and said her children didn't have a hand in the crimes with a bevy of information and Amelia's cooperation. The trial didn't last long when the judge ordered the jury to deliberate. It only took them five minutes to come back with a guilty verdict. The judge sentenced Amelia Dyer to death by hanging.

At nine a.m. on June 10th, 1896, authorities brought Amelia Dyer out of her cell to the gallows. They asked if there were any final words that Amelia would like to share. She responded in typical curt fashion. I have nothing to say. Seconds later, Amelia dropped through the floor and died. She was spared the awful deaths she subjected her victims to in execution hangings. The goal is to drop someone from a height that would cause a rope around their neck to sever their spinal cord and kill them.

Specifically, executioners will place the night of a noose on the side of a prisoner's neck right below the jaw. They will then pull the trap door underneath the prisoner, allowing him or her to fall at the end of their drop. The knot placement is meant to create a break in the neck bone known as the axes. This break then usually severed the spinal cord, causing death. These killings are instant and painless if carried out properly. Because of this, Amelia didn't suffer the agonizing asphyxiation she inflicted upon others.

In the end, some estimates suggest that Amelia killed as many as 400 children during 30 years of baby farming. In a letter to her son in law and her daughter, Amelia said she felt remorse for her actions. She hoped that she might be shown forgiveness when she got to Heaven's Gate. It's doubtful that the governess or the other mothers who trusted Amelia felt the same way. They wanted a better life for their children. But Amelia robbed the babies of their future.

They were left hopeless, broken and defeated. Tabloids throughout the country had a field day, Amelia was labeled an ogress while authorities had worked to curtail baby farmers in the past, Amelia's case brought the devilish practice to the forefront. Desperate mothers were now much warier of who they let adopt their children. Luckily, baby farming is now a thing of the past and safer options are available. Amelia Dyar story certainly sparked fear in parents all over the United Kingdom.

These crimes stand out not only because of who the victims were and the sheer number of them, but also due to their complete helplessness. And finally, Alistar, given the potential for mental health issues to turn dangerous and life threatening.

It's our responsibility to solicit help for those we fear are behaving in ways that provoke our concern. Amelia's bad combination of mental illness and drug addiction resulting in a slew of very tragic deaths.

Many consider Amelia Dya to be one of the most prolific serial killers of all time. In the end, her greed and wicked deeds caught up with her. However, her legacy of evil remains. Thanks for listening to medical murders and thanks again to Dr. Kipa for joining me today. Thanks, Alister.

See you next. Time for more information on Amelia Dyer.

Among the many sources we used, we found the book Amelia Dyer, Angel Maika, The Woman Who Murdered Babies for Money by Allison Rattle and Allison Vaill. Extremely helpful to our research. You can find all episodes of medical murders and all other podcast originals for free on Spotify, not only to Spotify. Already have all of your favorite music, but now Spotify is making it easy for you to enjoy all of your favorite podcast originals like medical murders for free from your phone, desktop or smart speaker to stream medical matters on Spotify.

Just open the app and type medical murders in the search bar. We'll see you next time.

Medical murders was created by Max Cutler and his Apakan studio's original. It is executive produced by Max Cutler Sound designed by Trent Williamson with production assistance by Ron Shapiro, Carly Madden, Kristen Acevedo, Jonathan Cohen, Jonathan Rateliff and Aaron Lawson.

This episode of Medical Murders was written by Robert Tyler Walker with writing assistants by Maggie Admire and stars David Kepa and Alistair Murden. Hang a horseshoe above your door, keep a rabbit's foot in your pocket and follow superstitions for a year on Spotify, listen every Wednesday for the surprising backstories to our most curious beliefs and thrilling tales that illuminate the mystical eeriness of our favorite superstitions.